…pain, but the effect on the bowel must be taken into account). Known allergy to the preparation — rare; itching and urticaria are usually due to…

…For example, in cardiac arrest due to pulmonary embolism the initial rhythm is typically PEA, which is explained by the fact that the embolus prevents…

…alkalosis due to hyperventilation, rhabdomyolysis (particularly the initial phase), sepsis, malignancies with osteoblastic metastases, diminished calcium absorption and/or enhanced calcium excretion, chronic renal failure…

…emerged, emphasizing the putative role of sensitized sensory nerve endings and afferent neural pathways in causing chronic refractory cough, akin to chronic neuropathic pain. This…

…elevation due to mechanisms other than myocardial ischaemia. Acute myocardial injury may arise from conditions such as sepsis, myocarditis, or takotsubo syndrome, while chronic myocardial…

…remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical manifestations may therefore…

…and infarction Definition and clinical rationale Stable angina, or chronic chest pain attributable to suspected chronic coronary syndrome, is evaluated by estimating the likelihood of…

Cardiology Evaluation and management of stable coronary artery disease Chronic coronary syndromes (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris …

ECG Evaluation and management of stable coronary artery disease Chronic coronary syndrome (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris …

…modified in some populations. Cardiometabolic mechanisms Visceral and ectopic fat are particularly relevant to cardiovascular risk. Excess adipose tissue promotes: Chronic, low grade systemic inflammation…

…comprise chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately 5–15% of pregnancies worldwide and are major contributors to maternal…

…exertion required to provoke symptoms. Response to current antianginal therapy. Adverse effects that restrict further drug escalation. Previous PCI, CABG, or attempted chronic total occlusion…

…cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with vasculitis Individual assessment Repeat the ABI every three to six months during…

…signs contribute to initial triage and that alternative cardiac and thoracic diagnoses must be considered. The immediate clinical categories include: Non cardiac diagnosis Chronic stable…

…drugs. Such treatment has not been shown to improve the prognosis and can cause hypotension, acute kidney injury, myocardial ischaemia or cerebral hypoperfusion. Pain, anxiety…

…Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from structural or functional abnormalities of the coronary arteries or…

…Chronic limb threatening ischaemia CLTI occurs when resting perfusion is insufficient to meet the basal nutritional requirements of tissue. Typical symptoms include: Ischaemic rest pain…

…A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to VSR. Large infarction, especially for septal or…

…clinical presentation and previous tracings when available. A prior ECG can help distinguish new abnormalities from chronic baseline findings, but comparison with an earlier tracing…

…acute chest pain or chest discomfort, with associated manifestations of myocardial ischaemia. In pregnancy, the clinical presentation of ACS is generally similar to that in…

…Q wave development relates more closely to infarct volume than to transmurality. Clinical Presentation and Symptoms Typical presentation Pain is the most frequent presenting symptom…

…coronary artery disease The underlying cause is atherosclerosis, which is a chronic inflammatory disease of the arteries. It has become increasingly clear in the past…

…ranging from chronic fatigue and exercise intolerance to sudden cardiac arrest. The most common acute symptoms are dizziness (pre syncope), hypotension (chock), syncope, chest pain…

…Erythematosus (SLE) Acute myocardial infarction (AMI) Post infarction (including Dressler syndrome) Uremia Radiation to the heart Trauma Tuberculousis Neoplasms (cancer) Post cardiac surgery (hemorrhagic pericarditis)…

…important in the setting of chronic or acute coronary artery disease. All types of ischemia– chronic, acute, or subacute –lead to regional abnormalities in contractile…

…raised pCO₂ Acute or acute on chronic hypercapnic respiratory failure Rapidly falling pH An urgent ventilatory problem Focal chest pain or unilaterally reduced breath sounds…

…chronic obstructive pulmonary disease, renal insufficiency, systemic hypertension, and concomitant abdominal aortic aneurysm. Clinical Presentation and Symptoms Acute chest and/or back pain is the…

…chronic stable angina include: sudden symptoms occurring at rest or with minimal exertion; symptoms lasting at least 10 minutes unless treated immediately; severe chest pain…

…segment of aorta involved, although the source material does not provide a detailed symptom to anatomy correlation. Pain may be absent, particularly in iatrogenic aortic…

…persistent or progressive disease suggestive of an advanced phenotype. Particular attention should be paid to potentially reversible causes and associated cardiovascular conditions, including coronary syndromes…

…urinary albumin to creatinine ratio (UACR) above 30 mg/g—or both. The eGFR is generally estimated from serum creatinine using the Chronic Kidney Disease…

…it may present with chronic angina, an anginal equivalent or exertional dyspnoea. Patients may continue to have lifestyle limiting symptoms despite guideline directed medical therapy…

Cardiology Coronary Atherosclerosis Coronary atherosclerosis is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental…

…a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction, immune cell recruitment, extracellular matrix remodelling, and thrombosis interact to…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…ischemia and infarction Pharmacology & dosing Definition and therapeutic objectives Antianginal therapy in chronic coronary syndrome (CCS) is directed primarily at reducing myocardial ischaemia and relieving…

…of chronic inflammation of the pericardium. In principle, all causes of pericarditis can result in constrictive pericarditis. In high income countries, idiopathic pericarditis, radiation to…

…Trauma Cardiac arrest caused by violence, accidents, burns, or other trauma. Drowning Cardiac arrest due to drowning Electrocution Cardiac arrest due to electrical current through…

…management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia? 2. Is the hyponatraemia acute or chronic? Severe symptoms…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…II, they may lead to the upregulation of bradykinin, which further enhances the effects of angiotensin suppression. In the context of chronic kidney disease, ACE…

…include: Symptoms attributable to chronic LV systolic dysfunction and HF Angina, although its absence does not exclude ischemic cardiomyopathy Symptoms related to recurrent ischemia Symptoms…

…unlikely to achieve the LDL C goal with statin therapy alone, initiation of high intensity statin plus ezetimibe during hospitalization should be considered. Chronic coronary…

…or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin identifies injury to myocardial cells, but…

…Group 3: PH due to chronic lung disease, hypoxia, or sleep disordered breathing Group 4: Chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease…

…cause a rupture in the left ventricular free wall. Mediastinal trauma : Penetrating injuries to the mediastinum can cause tamponade. Post operative Complications : Post surgical complications…

…further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart failure. Consider urgent angiography in patients with unknown etiology for acute severe…

…airway: a reduced level of consciousness not attributable to hypercapnia, marked swallowing difficulty, vomiting. Haemodynamic instability or a life threatening arrhythmia. Undrained pneumothorax. Facial trauma…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…threshold in traumatic brain injury Cerebral perfusion pressure (CPP) 60–70 mmHg CPP = MAP − ICP RASS −2 to 0 Lightly sedated to awake and…

…time, coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze…

…do the job, to reduce urethral trauma. The balloon is filled with sterile water according to the volume printed on the catheter , usually 10 mL…

…binding to plasma albumin, but the therapeutic effect remains unchanged. Sulfonylureas: Salicylates may potentiate the hypoglycemic effect of sulfonylureas, possibly due to reduced binding to…

…instrumental in identifying and staging chronic kidney disease (CKD), facilitating early intervention and management. Standardization: Its widespread adoption has led to standardized reporting of eGFR…

…Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to induced increase in myocardial O 2 consumption) Regular : 2.0–20 μg/kg…

…often recommended for PCI, while those with high scores (≥33) are typically advised to undergo CABG due to better long term outcomes. Intermediate scores (23…

…an advanced version of the original SYNTAX Score, designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the…

…MI are to: prevent recurrent MI; reduce ischaemic stroke and cardiovascular mortality; prevent stent thrombosis after PCI; reduce recurrent atherothrombotic events in chronic coronary disease…

…and SCORE2 Older Persons (SCORE2 OP) are European risk prediction models designed to estimate 10 year risk of both fatal and non fatal CVD events…

…lowering and other guideline directed therapies. Anti inflammatory treatment seeks to reduce this residual risk without necessarily altering lipid concentrations, blood pressure or other conventional…